NREMT Obstetrics & Gynecology Emergencies 3

Question 1

A patient delivers a baby in the field. After 20 minutes, the placenta has not been delivered. The EMT should:

Accepted Answer

Transport to the hospital; do not attempt to pull the placenta out

Answer

Placenta delivery normally occurs within 30 minutes of delivery. Attempting to pull or manually remove the placenta in the field risks uterine inversion and hemorrhage. Transport without manipulation.

Question 2

Postpartum hemorrhage is defined as blood loss exceeding how much after vaginal delivery?

Accepted Answer

500 mL

Answer

Postpartum hemorrhage (PPH) is defined as blood loss greater than 500 mL following vaginal delivery (or 1000 mL following cesarean section). It is a leading cause of maternal mortality worldwide.

Question 3

A pregnant patient at 28 weeks gestation has been in a motor vehicle collision and appears hemodynamically stable. The EMT should:

Accepted Answer

Position in left lateral recumbent to prevent supine hypotension, and transport to a facility with obstetric capabilities

Answer

Pregnant trauma patients should be positioned left lateral when possible to prevent aortocaval compression (supine hypotension). Obstetric capabilities at the receiving facility are important for fetal monitoring.

Question 4

What is the primary concern when a patient in the third trimester lies flat on her back during transport?

Accepted Answer

Supine hypotension syndrome from aortocaval compression

Answer

The enlarged uterus in the third trimester can compress the aorta and inferior vena cava when supine, reducing cardiac output and causing maternal hypotension (supine hypotension syndrome).

Question 5

An EMT arrives to find a woman who has just delivered in the back of a car. The baby is not crying, is limp, and has a heart rate of 70 bpm. The first intervention should be:

Accepted Answer

Dry and stimulate the baby while opening the airway

Answer

The initial steps for a newly born infant in distress are: dry, warm, stimulate, and open the airway. Stimulation alone may be sufficient to initiate spontaneous respirations. A heart rate of 70 is low but not below the threshold for immediate compressions.

NREMT Practice Test

NREMT Practice Test

NREMT Obstetrics & Gynecology Emergencies 3